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Canada: Pharmaceuticals

Canada: Pharmaceuticals - drug pricing and regulation

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Expenditure On Retail Pharmaceuticals Per Capita In US$ PPP, 2019
Prescribed Medicines: $738
Over-The-Counter Medicines: $73
Total: $811

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


Expenditure On Retail Pharmaceuticals By Type Of Financing, 2019 (%)
Government/Compulsory Plans: 39%
Voluntary Health Insurance Plans: 34%
Out-Of-Pocket: 27%
Other: 0%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


“Inpatient drugs are dispensed by hospitals without charge to patients as part of medicare. Outpatient pharmaceuticals, the cost of which may be covered in whole or part through public or private drug plans, are prescribed by physicians and in rare cases by other health providers who have the right to prescribe certain classes of drugs. Individuals obtain their prescription drugs at retail pharmacies. Almost all pharmacies, whether they are independent or part of a chain, sell a host of products beyond prescription and over-the-counter (OTC) drugs. Pharmacies in large chain grocery stores now compete directly with traditional stand-alone pharmacies by selling prescription and OTC drugs. In 2018 there were 10 692 retail pharmacies and drug stores in Canada of which two thirds were commercial chains (IQVIA, 2019).

“Pharmaceutical sales in Canada doubled from 2002 to 2017, with the majority of sales to retail drug stores (88%), and the remainder to hospitals (Canada, 2019d). In 2018 there were 29 802 Canadians employed in pharmaceutical manufacturing, mostly in the three largest cities: Toronto, Montreal and Vancouver. While there is some domestic pharmaceutical production, the majority of the pharmaceuticals in the Canadian market are imported (about 64%), mostly from the USA (38% of all imports) and the European Union (40% of imports) (Canada, 2019d).”

Source: Marchildon G.P., Allin S., Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3): i–194.


“FPT [Federal, Provincial, and Territorial] governments manage multiple drug plans for their populations; across Canada public drug plans vary in terms of the target populations, formularies and the extent and depth of coverage (CIHI, 2018d; see Chapter 3). There are over 100 public drug plans across the country, since PTs generally administer a catastrophic drug coverage programme for the general population as well as targeted benefits for specific subpopulations such as lower-income people receiving social assistance, older adults aged 65 years and older, and disease specific programmes such as for HIV and cancers. Unlike all other provincial plans, the Quebec drug programme is a mandated insurance plan in which private insurance plays a key role (Pomey et al., 2007). To add further complexity to these PT differences, eligible First Nations and Inuit patients are covered through the federal non-insured health benefits (NIHB) programme administered by Indigenous Services Canada. The one exception to variations in coverage for prescription drugs across jurisdictions is inpatient drug therapy: since prescription drugs provided in hospitals are considered insured health services and part of universal coverage, they are provided by all PT governments to all PT residents, including First Nations and Inuit, free of charge, by PT governments. Geographical variations in drug coverage and costs to individuals reflect this patchwork of programmes in place. For example out-of-pocket (OOP) spending on pharmaceuticals was lowest in Ontario ($ 402 per household, € 272), and highest in Quebec $ 534 per household, € 358); and spending on private drug plan premiums was also lowest in Ontario ($ 153 per household, € 103) and highest in New Brunswick ($ 396 per household, € 265) in 2016 (Morgan, 2018a).”

Source: Marchildon G.P., Allin S., Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3): i–194.


“All provinces offer a public drug-benefit plan for community-based drug purchases.6 Public drug coverage is concentrated among older people and individuals on social assistance, but all residents are potentially eligible for coverage in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and Québec, albeit with greater cost-sharing for working-age and/or high-income individuals (Canadian Institute for Health Information, 2012). British Columbia and Manitoba changed from age-based coverage criteria to income-based criteria in 2003 and 1996, respectively. In 1996–1997, Québec introduced a novel public and private financing arrangement for its universal drug coverage scheme, Canada’s only explicit public–private insurance partnership (see Box 4.2). Public expenditure on drugs varies across the provinces, ranging from a low of 33–37% of prescription drug expenses in Atlantic provinces (Newfoundland, Prince Edward Island, Nova Scotia and New Brunswick) to nearly 50% in Saskatchewan (Canadian Institute for Health Information 2015).”

Source: Jeremia Hurley and G. Emmanuel Guindon. “Private health insurance in Canada.” In Private health insurance : history, politics and performance. Thomson, S., Sagan, A., & Mossialos, E., Eds. (2020). Cambridge: Cambridge University Press.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated Oct. 23, 2022 by Doug McVay, Editor.

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